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Are your health care choices being made by pharmaceuutical middlemen and mail order pharmacies? Protect access to prescription medications from local pharmacies. Contact your Members of the U.S. House of Representatives TODAY!

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Issue Spotlight

Support Pharmacy Choice in Medicare

Click here to send an email to your members of Congress to urge them to co-sponsor H.R. 793/S. 1190, the Ensuring Seniors Access to Local Pharmacies Act. This bipartisan legislation would improve pharmacy choice and competition in Medicare Part D in areas that are designated as either a health professional shortage area or medically underserved community by allowing any pharmacy willing to accept contractual terms and conditions to serve as a preferred pharmacy in Medicare Part D plans.

Currently, some part D plans offer "preferred" pharmacies that are able to offer lower levels of consumer cost sharing than other network pharmacies. These preferred pharmacies are cherry picked by the plans even though other pharmacies are willing and able to accept the same contractual terms and conditions as the preferred pharmacies and willing to offer consumers the same cost sharing levels. Yet, even in these medically underserved areas the plans deny willing pharmacies this opportunity, necessitating a legislative remedy from Congress.

Support Fair Reimbursements to Pharmacies to Maintain Patient Access

Click here to send an email to your members of Congress to urge them to co-sponsor H.R. 244, the MAC Transparency Act. This bipartisan legislation would help ensure insurance reimbursements to pharmacies better reflect market conditions.

Patients need reliable access to community pharmacies, which need fair reimbursement to stay in business. About 80 percent of drugs dispensed are generics, which pharmacists promote to help save beneficiaries and Medicare money.

Prices for many generic drugs are skyrocketing by 1,000% or more virtually overnight, yet Medicare drug plan middlemen known as pharmacy benefit managers (PBMs) may wait months to update reimbursement. That leaves independent community pharmacies with losses of $40 to $100 or more per prescription. Such losses are unsustainable for community pharmacies or any other small business.

Urge your members of Congress to support H.R. 592/S. 314 to recognize pharmacists as healthcare providers under Medicare. Millions of Americans lack adequate access to primary health care because of primary care physician shortages in their communities, despite many of these patients having health insurance coverage. With an additional 36 million individuals potentially gaining health coverage under the Patient Protection and Affordable Care Act (PPACA), the physician shortages will only be exacerbated. The Association of American Medical Colleges has projected that there will be more than 91,000 fewer doctors than needed to meet demand by 2020.

Pharmacists are capable of playing a greater role in the delivery of health care services. Pharmacists who utilize their education, training, and license can provide services that include health and wellness screenings, managing chronic diseases, administering immunizations, medication management, and working in and partnering with hospitals and health systems to advance health and wellness and helping to reduce hospital readmissions.

About Fight4Rx

Pharmacists play a role every day in the lives of patients by improving health care while reducing costs. With health care issues taking center stage in Washington, DC, it is vital that patients remain engaged in protecting their access to safe and affordable medicine. Fight4Rx™ provides you with the tools you need to learn about the changing health care market, and how your community pharmacy plays a key role.

Consumer surveys conducted by J.D. Power and Associates, Consumer Reports, and Boehringer Ingelheim consistently reflect that independent community pharmacies garner among the highest customer satisfaction scores, surpassing national, publicly traded pharmacy chains and the most common, volume-driven mail order pharmacies.

Whorunsmydrugplan.com

Pharmacy benefit managers, or PBMs, act as an intermediary between the payer and everyone else in the healthcare system. They generally make money through service fees from large customer contracts for processing prescription claims, operating mail order pharmacies, and negotiating prices with drug makers. Go to whorunsmydrugplan.com to learn more.

The letter below could serve as a sample for your own letter to your health plan.